摘要:

SUMMARYOne hundred and ninety‐five magnetic resonance (MR) images (1.5 Tesla) of 167 patients with neurological impairment following spinal trauma were reviewed.Acute cord injury produces central haemorrhagic necrosis that extends transversely and longitudinally with time and increased injury severity. Oedoma is more homogeneous, extensive and dominant in minimal lesions. Magnetic resonance appearances correlate with neurological status and outcome. Patients with MR evidence of cord blood had severe clinical lesions and failed to show useful clinical improvement. Patients with homogeneous ‘oedema’improved to useful function. Lesion signal inhomogeneity relates to a worse prognosis. The clinical level correlates closely with cord blood or signal in homogeneity but imprecisely with homogeneous oedema. Disc herniations require differentiation from epidural blood and venous engorgement, which are prominent with bone displacement. Magnetic resonance is recommended in incomplete cord syndromes and in cord injuries with no apparent fracture, particularly if clinically deteriorating.Chronic injury consists of cavitation, extensive gliosis, cord atrophy and leptomeningeal fibrosis. Progressive myelopathy may result from cystic or non‐cystic intramedullary lesions. Cord cysts are common and cyst fluid signal should closely follow cerebrospinal fluid. Turbulent cyst fluid motion is commoner in larger cysts and may predict those cysts more prone to propagate. Progressive syrinxes show typical appearances, usually with transverse septa. Atrophy and propagating syrinxes usually take years to develop. Leptomeningeal cysts and spinal stenosis caused by bone displacement and accelerated adjacent disc disease may cause late deterioration. In progressive myelopathy following injury, surgically drainable cysts are clearly differentiable from cord gliosis and

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00191.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYCytomegalovirus (CMV) is a recognized cause of biliary abnormalities in acquired immune deficiency syndrome (AIDS) patients. In a prospective trial, two of 25 (8%) of AIDS patients on treatment for CMV related infections without biliary symptoms were found to have biliary dilatation on ultrasound. The study confirms previous findings of the poor correlation of sonographic findings with clinical status and biochemical profiles, and demonstrates that biliary tree dilatation in this group of patients may notper sewarrant further invasive investigation.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00192.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYThis is a retrospective study of 15 patients who had bronchial artery angiography and embolization for life‐threatening haemoptysis in the period January 1986 to March 1993. Eight were male and seven were female, in the age range 32–77 years. Massive haemoptysis has a 50–100% mortality if treated conservatively and surgery has an up to 35% mortality in this high‐risk group.Nine patients had advanced tumours. Seven had technically successful procedures, with haemoptysis being controlled in six and one patient dying from post‐procedural massive haemoptysis. One of the patients with failed embolization died from massive haemoptysis and the other had spontaneous settling of bleeding.The other six patients suffered from bronchiectasis (2), aspergilloma involving tuberculous cavity (2), active tuberculosis (1), and abscess cavity presumably due to vasculitis (1). Technically successful embolizations were achieved in all six; three had control of haemoptysis, one required successful re‐embolization after massive bleeding following initial embolization, one suffered continuing non‐massive bleeding and one died soon afterwards from massiv

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00193.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYThe case of a solitary diverticulum of the appendix found on routine barium enema is presented. The types of diverticula, their presentations and their potential outcomes and significance are discussed.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00194.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYCarcinoma of the breast with sarcomatous metaplasia (CSM) is a rare and interesting tumour with a poorer prognosis than the usual breast malignancies. The mammographic appearances of this lesion have only previously been described once in the literature. A case of CSM is presented with mammographic‐pathological correlation and review of the literatur

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00195.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYShoulder impingement syndrome is commonly encountered in orthopaedics. In a blinded retrospective study, magnetic resonance imaging and roentgenographic signs in 41 patients with clinical signs of impingement syndrome were compared with 40 control patients. Statistically significant differences between the groups included the absence of subacromial fat, as well as the presence of a supraspinatus tear, subacromial osteophytes, and a decreased coracohumeral distance. Other signs reported to occur in patients with impingement syndrome did not vary significantly in the population studied.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00196.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYSegmental variations in vertebral body cancellous bone architecture throughout the thoracolumbar spine were examined using histomorphometry and microradiography, and compared to bone mass measured using dual energy X‐ray absorptiometry. In six human vertebral columns (T1 to L5) bone mineral content (BMC) and bone mineral density (BMD) of each vertebral body was determined in the lateral projection. Sagittal plane cancellous bone architecture was assessed from two‐dimensional surface stained images and microradiographs of two 1 mm thick sections at each vertebral level. Computer‐assisted image analysis was used to measure the total bone area (TBA), mean trabecular width (MTW) and trabecular number (TbN) from the stained images, and the skeletonized network length (SNL) from the radiographic images. Consistent segmental trends were observed for all structural parameters across the six columns examined. Higher TBA and TbN values were observed in the upper thoracic segments and decreased caudally. The MTW was relatively constant in the thoracic vertebrae before increasing in the lumbar spine. Pooled correlations between TBA and the bone density measurements were poor (BMC:r=0.17, BMD:r= 0.25), while the TBA and SNL were only moderately correlated (r= 0.42). In conclusion, histomorphometric and radiological measurements appear to provide different information about cancellous bone structure. Bone structure is poorly correlated to integral measurements of bone mass. The consistent segmental variations in bone architecture appear to reflect a skeletal response to the relative extent of habitually applied loads in different regions of the

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00197.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYThree cases of congenital absence of a cervical spine pedicle are described. This anomaly comprises a radiological triad of (i) the absent pedicle producing an apparently ‘giant’neural foramen; (ii) a dorsally displaced ipsilateral articular mass and lamina with a dysplastic and reversed facet joint; and (iii) deficiency or absence of the ipsilateral transverse process.Recognition of this anomaly is particularly important in the context of acute injury to avoid misdiagnosis as a traumatic facet joint fracture‐dislocation. The giant foramen must also be differentiated from expansion due to a neurofibroma. A correct plain radiographic diagnosis is usually possible, but in doubtful cases appearances on computed tomography are pathognomonic.Magnetic resonance imaging, performed in two of the cases, was helpful in elucidating the contents of the giant foramen, but should rarely be necessary in clinical pra

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00198.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYA case of abdomino‐scrotal hydrocele diagnosed on sonography without clinical suspicion is reported with a review of the literatur

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00199.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SUMMARYFifty‐two fracture sites were evaluated by bone scintigraphy after acquiring similar views of the lesions at 4 and 24 h following technetium‐99 m methylene diphosphonate administration. After calculating 24/4 h radio‐uptake ratio (RUR) and using 1.15 as the critical point of separation, fresh healing lesions could be separated from old healed fractures persisting as ‘hot spots’with a sensitivity of 100% and specificity of 82%.The 24/4 h RUR technique is a new approach in measuring the osteoblastic activity at the lesion site. The technique appears to have clinical significance in the detection and follow up of the healing status of occult fractures where radiological procedures are of limi

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1994.tb00200.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY